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Treatment for deep vein thrombosis (DVT) is designed to stop existing blood clots from getting bigger, preventing blood clots from breaking off and traveling to the lungs (pulmonary embolism), and reducing the likelihood of another blood clot forming.
The first line of treatment is usually medication, including:
- Anticoagulants. These medications decrease the blood’s ability to clot. They are used in patients who experience symptoms to prevent clots from enlarging or to stop new clots from forming. They do not break up existing clots. Depending on the severity of the DVT, anticoagulant therapy may begin immediately after diagnosis and continue for several months (usually 3 to 6 months). If the patient has other conditions that may contribute to the DVT (e.g. cancer), anticoagulant therapy will often last as long as those other conditions are present. Anticoagulant medications may be administered in the hospital (e.g., heparin), followed by an oral prescription (e.g., warfarin). It is very important to closely monitor anticoagulant medications, using the international normalized ratio (INR), closely while they are being used to reduce the risk of bleeding. Newer forms of heparin have been studied that allow for safe treatment of DVT without hospitalization.
- Clot-busting drugs (thrombolytics). These medications dissolve existing blood clots. They are frequently used among stroke patients to rapidly dissolve blood clots that occur in the brain. However, in DVT their use is somewhat controversial, since anticoagulant therapy is effective and thrombolytics are connected to increased bleeding and many DVT patients also recently had surgery, which would prohibit the use of clot-busting drugs. Their use is usually reserved for severely symptomatic blood clots that are life-threatening.
- Thrombin inhibitors. These are newer medications that interfere with the blood’s clotting process. They are often used with patients who cannot tolerate anticoagulation.
If a patient cannot tolerate medications for one reason or another, the physician may choose to implant a vena cava filter. This is a basket-like filter that is placed into the large vein that drains the legs and lower extremities, the inferior vena cava. The filter is designed to prevent loose blood clots from reaching the lungs and causing a pulmonary embolism.
Finally, the physician may prescribe graduated compression stockings. These stockings are worn from the foot to the just above or below the knee. They are tight at the ankle and gradually provide less pressure as they move up the leg. This aids upward blood circulation and reduces swelling in the legs that results from damage to the valves in the veins.
It is very important that compression stockings be worn according to the physician’s instructions. Despite the fact they can be hot and sometimes difficult to put on, studies have shown that poor compliance rates with the stockings hinders their effectiveness. Newer stockings are available that use Velcro fasteners.
Besides these therapies, a physician may also recommend reducing the number of risk factors for DVT. This may include walking regularly to get exercise and stimulate circulation, avoiding activities that may cause serious injury to the legs and diet modification. | 
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